以脊椎麻醉進行剖腹產手術中突然發生嚴重性的Bezold-Jarisch反射之病例報告

Occurrence of the Bezold-Jarisch Reflex during Cesarean Section under Spinal Anesthesia-- A Case Report

雖然較高的脊椎麻醉是會引起心律變慢的情形，但是在剖腹生產中，在胎兒以及胎盤都已經順利產出時才發生，這並不常見。一位三十五歲的女性，除了有妊娠糖尿外，平時身體非常健康，在剖腹生產手術中發生了這種情形，在當時合併有大量出血的狀況，由於病人沒有心血管系統或是呼吸系統方面的併發症發生，我們高度的懷疑，當時突發了一個致命的Bezold- Jarisch reflex。另外有妊娠糖尿的病人，是否也會加重這類反應的發生，也是值得去注意的事情。由於當時快速處理得宜，病人並無留下任何後遺症，康復出院。

We report a 35-year-old parturient with gestational diabetes mellitus (GDM) history who sustained a nearly fatal Bezold-Jarisch reflex during Cesarean section under spinal anesthesia. A high spinal block combined with acute massive hemorrhage may produce life-threatening Bezold-Jarisch reflex which should be treated prophylactically and aggressively during surgery. Additionally, the autonomic disturbance associated with GDM might exaggerate the reflex in this episode. The patient survived after successful resuscitation and was discharged without any sequela.